Stomachache

[BunnyBunnyBSNRN, ASN, BSN]

Hi All!

I've been a school nurse for a year and a half now, so I've seen my share of "Miss, my stomach hurts". I'm wondering how ya'll handle it. I ask if they've eaten breakfast, do they feel like vomiting, have they vomited today, and when the last time they went poop was. Also, I have them point (with one finger) to where it hurts and take a temp. If all is neg, and depending on how the clinic is at that time, I'll let them lay down for a bit and then send them back. If it's a FF, I set a timer for 5 minutes and send them back after that. I guess I'm just looking to see what everybody else is doing and if I'm on track.

Thanks!

sara

[Flare, ASN, BSN]

I pretty much do the same routine. Granted, there are always the few times that you send the kid back to class (no fever, looks overall ok) and they throw up within 10 minutes -these instances can make you question your judgement.

[tewdles, RN]

I would only add that I would notify the parent of the complaint, especially if the child is a FF.

Reminds me of a case from my years in PICU. School aged child reported to school nurse several times about abd pain, ended up with a dx of wilm's tumor.

[mustlovepoodles, RN]

That's pretty much my routine, too. I don't ask them to rate the pain, because they all say it's "the worst pain ever.":uhoh3: I play it real cool. I take temp, aske them to point to the pain, ask if they vomited. Then I tell them to jump up and down three times. This is the acid test: A kid with appendicitis or something else serious won't even try this because they KNOW its going to hurt. The ones with gas or cramps or some other benign something will look at me like I"m crazy, start jumping and then fall apart laughing. If they're laughing, it's not serious. My magic cure is ice water. A cup of ice water and a trip to the bathroom usually does it. Every now and then I send one back to class and he/she throws up later. Oh well. At that point I send them home. But I don't call every parent about the stomachache unless it's a FF. With FFs I usually do call the parents so they're on notice that something is going on (this is assuming I've already had the "what does your ped say?" convo with them.) With FFs I rarely allow them to lay down and if I do there's no books, toys or talking allowed. Either you're sick or you're not. If they feel like chattering away, they can go back to class.

[Purple_Scrubs, BSN, RN]

My routine is the same: temp, point to pain, last meal, last BM, rest 10 minutes. I really like the "jump up and down" test, I am sooo stealing that! :)

[mustlovepoodles, RN]

Be sure that if the child either can't or won't jump, or if the jump causes true pain that you call parents and send home. That jumping manuever is something I learned from an old ER doc. He used it to ferret out the kids with appendicitis and bowel obstruction. As I said, those kids will rarely even try that exercise.

[mc3, ASN, RN]

My routine is the same: temp, point to pain, last meal, last BM, rest 10 minutes. I really like the "jump up and down" test, I am sooo stealing that! :)

me too!

:)

mc3:nurse:

[OncallRN]

love the jump up and down... adding it to my eval too